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_____________________________________________________________________________________ Urinary Tract Infection Andrew B. Crocker, Extension Program Specialist – Gerontology Health A urinary tract infection (UTI) is an infection that begins in your urinary system. A UTI limited to your bladder can be painful and annoying; however, serious consequences can occur if the UTI spreads to your kidneys. Older adults are among those at the greatest risk of kidney damage due to UTIs because their symptoms are often overlooked or mistaken for other conditions. The urinary system is composed of the kidneys, ureters, bladder, urethra and prostate (in men). UTIs typically occur when bacteria enter the urinary tract through the urethra and begin to multiply in the bladder. The most common UTIs occur in women and affect the bladder and urethra. Half of all women will develop a urinary tract infection at some point during their lives and many will experience more than one. Not everyone with a UTI has symptoms, but most people get at least some symptoms. These may include a frequent urge to urinate and a painful, burning feeling in the area of the bladder or urethra during urination. It is not unusual to feel bad all over and to feel pain even when not urinating. It is common for a person with a UTI to complain that, despite the urge to urinate; only a small amount of urine is passed. The urine itself may look milky or cloudy, even reddish if blood is present. Normally, a UTI does not cause fever if it is in the bladder or urethra. A fever may mean that the infection has reached the kidneys. Other symptoms of a kidney infection include pain in the back or side below the ribs, nausea or vomiting. UTI is among the most common infections in patients with dementia. This is believed to be for a number of reasons including reduced immune response, incontinence in women and urinary retention in men. In many instances UTI may exacerbate a patient’s dementia symptoms. In fact, UTI may itself cause problems with cognitive function, most commonly acute confusion. Treatment may often immediately remedy the situation. Other risk factors for developing UTIs may include, but are not limited to: • Being female. Women have a shorter urethra, which cuts down on the distance bacteria must travel to reach the bladder. • Being sexually active. Sexual intercourse can irritate the urethra, allowing germs to more easily travel through the urethra into the bladder. • Aging. After menopause, UTIs may become more common in women because tissues of the vagina, urethra and bladder become thinner and more fragile due to loss of estrogen. Too, in men, an enlarged prostate may prevent the bladder from emptying completely upon urination and increase risk of UTI. -OverAgriculture and Natural Resources · Family and Consumer Sciences · 4-H and Youth Development Extension programs serve people of all ages regardless of socioeconomic level, race, color, sex, religion, disability, or national origin. The Texas A & M System, U.S. Department of Agriculture, and the County Commissioners Courts of Texas Cooperating • • Kidney stones or any other urinary obstruction, including prolonged catheter placement Diabetes and other chronic illnesses that may impair the immune system. The National Kidney and Urologic Diseases Information Clearinghouse recommend these steps to reduce your risk of urinary tract infections: • Drink lots of fluid to flush the bacteria from your system – water is best. • Drink cranberry juice or take vitamin C. Both increase the acid in your urine so bacteria cannot grow easily. Cranberry juice also makes your bladder wall slippery so bacteria cannot stick to it. However, persons on certain medications should avoid cranberry juice so be sure to discuss this with your health provider. • Urinate frequently and go when you first feel the urge. Bacteria can grow when urine stays in the bladder too long. • Urinate shortly after sex. This can flush away bacteria that might have entered your urethra during sex. • After using the toilet, always wipe from front to back, especially after a bowel movement. • Wear cotton underwear and loose-fitting clothes so that air can keep the area dry. Avoid tightfitting jeans and nylon underwear which trap moisture and may help bacteria grow. If your health provider suspects you have a UTI, he or she may ask you for a urine sample to determine if pus, red blood cells or bacteria are present in your urine. Analysis of the urine, sometimes followed by a urine culture, may reveal whether you have an infection. If your symptoms are typical of a UTI and you are generally in good health, antibiotics are the first line of treatment. Which drugs are prescribed and for how long depends on your health condition and the type of bacteria found in your urine. When treated promptly and properly, UTIs rarely lead to complications. But left untreated, a urinary tract infection can become something more serious than merely a set of uncomfortable symptoms. Untreated urinary tract infections can lead to acute or chronic kidney infections, which could permanently damage your kidneys. Urinary tract infections can be painful but you can take steps to ease your discomfort until antibiotics clear the infection. In addition to following your health provider’s instructions and completing the full course of antibiotics, these tips might provide you some relief: • Drink plenty of water to dilute your urine and help flush out bacteria. • Avoid coffee, alcohol and caffeinated soft drinks – these may irritate your bladder and contribute to your frequent need to urinate. • Use a heating pad on your abdomen to minimize discomfort. For more information, contact The National Kidney and Urologic Diseases Information Clearinghouse, a service of the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health: http://kidney.niddk.nih.gov/kudiseases/pubs/uti_ez/. Distributed by: Marilyn H. Simmons, County Extension Agent – Family and Consumer Sciences AgriLIFE Extension Services – Galveston County, [email protected] 281-534-3413 ext. 2-3 August 2008